Ideas based on my personal experiences in learning how to manage type 2 diabetes. I stress that I am a diabetic, not a doctor nor a dietician. I have no medical qualifications beyond my own experience. Nothing written here is intended as medical advice, and any ideas you may decide to use should be discussed first with your doctor.

Weight Loss Cooking and Eating Plan

This is not so much a diet as a general guide to cooking and eating. There are no absolutes. If you find any value in my experience – terrific. However, what follows is purely my own method of dealing with my own situation. It is also a work in progress – because what I needed was a "way of eating" that I could comfortably follow for the rest of my life. Not just a short-term weight loss diet. The plan was developed over a few months after I was diagnosed with diabetes and leukemia in early 2002. It is based on a distillation of research on the internet, advice from doctors, a course with a dietitian and general reading on the subject over some years.

It is titled "weight loss phase" because I did it in stages – first I lost weight, then used my meter to modify my menu for better blood glucose numbers, then I refined the result to improve various other aspects for health and nutrition. I’ll post on that later. In April 2002, at the time I was advised I had type 2 diabetes, I weighed 117 Kg or 257 lbs. Like many fat people I was adept at not getting my photo taken so I don't have many to choose from that era.

By Christmas 2002 I weighed 94 Kg or 207 lbs, a loss of 23 Kg or 50 lbs. Equally important, I was reasonably fit (apart from a few incurable diseases!), I didn’t feel hungry and I didn’t put it all back on over the Christmas/New Year feasting period. This is taken in Pisa in May 2003 on our first World Trip, the other was taken in August 2006 in Hawaii on the second trip.

I wrote the first version of this in early 2003, when some friends on the CLL list asked for a copy of my "diet". So I had to write it down for them. Since then I’ve travelled a lot, eaten out a lot, and learnt a lot. And I’ve still kept the weight off. I’ve re-written it slightly to be specific for type 2 diabetes. So I’ve worded it on the assumption that not only does the reader need to lose weight – but also wants to reduce excessive blood glucose (BG) numbers. In effect, to compress my first two phases into one. This is only the starting point. As time goes on and weight comes off the constraints on fat can be eased – but your meter will show you that the constraints on carbohydrates tend to remain.

All types, regardless of fat content. Skim milk will actually cause bigger BG spikes. Cheese – I eat full-fat cheese, but less of it; I cannot stand "plastic"low-fat cheeses. I use low-fat cheeses like cottage, ricotta, Philadelphia in dips where I can add flavours. Take Calcium supplements if necessary to replace the loss of dairy calcium - however I added some yoghurt which helped there (see later).

Good Snacks

Fruit in moderation (use your meter to define moderation), nuts in small portions, avocado. Low-fat crackers or vegetables with dips such as hommus or guacamole etc. Slices of crisp veges (celery, carrots etc) with dips. Experiment with cottage cheeses, ricotta, lo-cal Philly, avocadoes, onions, peppers etc. Add a little plain yoghurt to your day, flavoured with fresh or frozen berries and a little artificial sweetener. If you must have a slice of bread, leave off the marg/butter and use a thin smear of the spread (not jam) of your choice. And make it a half-slice.

Lots of Variety

Vary meals and menus as much as possible to prevent boredom. Experiment by creating tasty dips etc for snacks, adding unusual spices to casseroles or marinades etc (but always have a stand-by in the freezer to allow for the occasional inedible disaster).

Guilt and Failure

I allow myself a "guilt-free" day or meal occasionally. Pizza, fish and chips (deep-fried battered fish with french fries for those people who drive on the wrong side of the road), chocolates etc. However, try to keep the portion size to a minimum or cook it at home (see tips below). Yes, I know, it’s impossible to eat one chocolate out of a full box. But try. If you allow this luxury it makes it easier to return to the plan, rather than to think "well I’ve blown it, so what the heck!".

Cooking and Preparation Tips

Saturated Fat Elimination/Reduction

Trim all fresh meats carefully to discard as much fat as possible. Do not use processed meat (e.g. all sausages, salami, bologna, chicken roll etc.) Do not eat take-away chips (fries) etc. Most are cooked in saturated fats. Substitute deli sandwiches (careful of the bread – I often discard the top piece) , salads etc for take-away. If you’re caught with a group at a take-away have salad (watch the dressing), skin-free chicken or just a very small serve. Grill (Broil?) meats when possible so that fats drain during cooking.

Other Fats

Although some other fats are good, I still try to reduce their quantity. Use cooking sprays instead of butter or spoonfuls of oil for cooking. Use a thin smear of mayo or a spread you like instead of marg/butter on sandwiches or rolls and don’t have the top half of the bun or the top slice of bread. Experiment. Cook casseroles in advance and cool in the refrigerator (or strain the liquid and cool separately before re-combining). The saturated fat will rise to the top and solidify and can be removed before re-heating or thickening. Similarly, reduced fat gravies can be made from pan juices by pouring them off into a jug and skimming. Add some ice cubes to speed up the process if the diners are waiting. They will still contain fat, but not as much.

Use a non-stick pan or griddle. Most meats will not need additional oil to cook, or will only need a light spray from a cooking oil. If you must deep-fry (a rare luxury – see "guilt-free" days), use a vegetable oil (preferably peanut, not palm or coconut), wait until the oil is at the correct temperature before adding the food, don’t overcrowd the pan (this would reduce the temperature and cause the food to absorb more oil), and drain the fried food well on kitchen paper before serving. When I say it’s a luxury, I fry fish once a fortnight (two weeks) but I oven fry the chips.

Oven fry french fries – cut them large (not like thin McDonalds), throw them in boiling water until not quite cooked (still firm), spray an oven tray with cooking oil then place the "fries" on the tray and spray again lightly. Cook in the oven at about 200c (390F) until done. Use your meter to see what portion size you can handle. Mine is three chips.

Sugars

I won’t buy into the arguments about sweeteners. People say some may give you cancer. Do you think that worries a Diabetic/CLLer? Find the sweetener and lo-cal drink that you like (or that you dislike least) and consider all things flavoured with sugar as poison. If you must eat them, make it a special and rare treat.

Carbohydrates

You need carbs for energy, fibre and brain food, but steer clear of the white starches. A moderate intake of grains, cereals and legumes will keep you regular, reduce the risk of bowel cancer and provide variety in your diet without adding excess weight (provided you are sensible about portion sizes). However, once again – your meter will be your guide to your limits there. It is likely that you will be cutting back drastically on your present carb intake- add other sources of fibre, particularly leafy or green veges; I also add psyllium husk to my daily menu for extra fibre without extra kj/cals or BG spikes.

Alcohol is a very personal issue, so that is one to be discussed directly with your doc. Personally, I drink 2 or 3 glasses of good red wine a day. One of the pleasant things I discovered by blood glucose testing is that a good red wine helps reduce my numbers. Unfortunately, too much of a good thing makes them go up again! I have the occasional (2 or 3 a week) scotch or rum and lo-cal mixer. This is probably more than the doctor would recommend – but (as I’ve learnt) life’s too short to give up all the good things.

Nutrition Labels – Important!

Learn to read nutrition labels on the packet. Until you start to read them you don’t realise just how much variation there is in the fat, carbohydrate and sugar content of the products you buy. Modify your purchasing habits as a result. If an article is advertised as low fat or low cal but there is no nutrition detail – it’s probably false advertising. Be very wary of "lite" or "97% fat-free"; they often compensate for the reduced fat by increasing the sugar content and can contain more kilojoules/calories than the standard product.

My Personal Diabetic Eating Rules

These apply only to me. They may or may not apply to other type 2 diabetics. Find out what does apply by testing one and two hours after every meal or snack until you know what you can eat, when you can eat it, and how much you can eat in a serve.

There are five small meals a day – breakfast, lunch, afternoon tea, dinner, supper, not more than three to four hours apart. No carbohydrates before lunch, then I gradually increase carbs at each meal until supper. I eat my cereal as my final meal (my morning regularity has significantly improved).

Minimise or eliminate serves of white starches, most fruits, all high Glycemic Index (GI) foods. Replace high GI with low, e.g. multigrain bread for white etc.

Maximise low-carb and low GI vegetables such as cabbage, celery and cauliflower.

Jams, high sugar relishes, high fat and high sugar crackers etc are poisons that other people eat. Convince your mind that these people don’t know how bad they taste. It’s a mind game, but don’t start telling your partner not to eat them unless you want a divorce.

Discipline

Set a healthy target in consultation with your medics, then set smaller targets (say 2.5 Kg or 5lb) on the way to your goal and celebrate in some way each time you reach the target. Involve those you care about so that they can encourage you. It won’t work if you quit, and you will quit if you don’t get results. Weigh yourself regularly and record the results. Don’t get dejected if the waistline or weight doesn’t go down every day – the body seems to take time to adjust to the changes. In my case I lost 3 Kg (6 ½ lbs) in the first week, but this stabilised to an average of about a kilo (2 lbs) per week and later to half a kilo. There were some weeks or months when I seemed to hover or even go up, but then I would lose a lot in the next week.Postscript and Restaurant Eating

PS. Aug 2003. After writing the original cooking and eating plan we spent five months travelling the world. I didn’t gain weight but we left a reputation behind us as Aussie cheapskates because, wherever we went, we would order one main course and a spare plate for the two of us. It took some cheek, but we didn’t put the weight back on (and also saved some cash :-) Where it wasn’t possible because of language or embarrassment of others, we would order a main course and a side salad or starter – just to get the plate – then mix between the two. This allowed me to leave the high GI or high carb items for my non-diabetic wife.

We often found that we still left food on the plate, even when we shared. Because the food is actually the smallest cost in running most restaurants many provide enormous serves to attract customers. If you are eating alone in a restaurant it takes more discipline to leave over half the food when you know you are paying for it. But if you eat it, you will pay much more eventually. Specify that you absolutely, definitely do NOT want chips/fries. Many restaurants add them automatically.

33 comments:

Anonymous
said...

Alan, It's Lloo from the ADA site. I love this place. Your travels soundwonderful and what you say of your eating plan sounds so much like mine.I don't eat nearly the carbs manyothers do. And like you, I find somewine or an occasionally rum and diet7-up lowers my no's. Cheers.

Alan, this is Sharon from the ADA site. What a wonderful website and diet plan. My dietician initially balked at my low carb diet, but she agrees that the carbs are what spike you blood glucose. Thank you for this website. You sound like you would be great fun to be around.

Alan....Wow, you said it all in a nutshell ! I have read and learned from your experiences. I never heard about the skim milk spikes and I drink lots of skim milk daily. I have even used skim milk more since I went on insulin !! I will definitley be checking into that info.

Your plan makes lots of sense and speaks to the real people - like me - who are human and cave in to dangerous foods every now & again. I am one of the lucky ones that can eat pizza without major reprecussions, so that is a treat for me.

I have a friend who avoids all things white and has kept weight off for years & kept DM at bay. Thanks for putting your thoughts & ideas down on paper (on keyboard. I appreciate your support in my quest.

Where will you & the wife go on the next trip? In Turkey, you can order half portions when you eat at the "local" eateries. :-)

Hi AlanThank you so much for taking out time to write all this for us newbies.I have yet to be diagnosed, but I was told I have a high/ normal glucose on my blood test, and high colestorol. ( sorry about spelling)I also have symptoms, am overweight, and the right age for it.I was wondering when you say root vegetables, do you mean carrots and radishes too?and is corn on the cob ok?Thank you again for all your help.You are a God Send.Bless You!

Yes,I mean all root vegetables. I don't mean that they will all necessarily raise your blood glucose levels, but I do mean that you should be very cautious about including them in your menu until you have used your meter to find what portion sizes you can tolerate and which meals allow you a higher portion size.

Personally, I can eat raw carrots in reasonable quantities but the portion size has to be reduced if they are cooked. Radishes, in small portion sizes, have little effect on me.

Other starches such as corn on the cob can have a very significant effect. Once again you have to test for yourself but my own limit is 1/3 cob as a portion.

On whether or not you have diabetes do not accept vague generalisations such as "high/normal glucose". Ask for direct answers and get copies of all your blood tests.

But also make sure you organise the best insurance you can before you are officially diagnosed with diabetes.

Fruit has many nutrition benefits. However, it also has dangers for the diabetic so must be treated with some care.

No matter how nutritous it is, fruit is packed with carbohydrates; mainly in the form of sucrose and fructose. If you have diabetes you need to test it, using your meter after eating, to find the portion sizes that you can tolerate at different times of day. If you are not diabetic, you still need to be aware of the carbs and calories in fruit.

Like all foods fruit needs to be treated with a bit of caution until you know what it does to you.

Alan, this was very helpful! I was diagnosed last week and felt a little abandoned by the doctors when I wasn't given any information except phoned instructions to pick up prescription of Metformin, and come back in 1 month. It's good to see there are others dealing with these health concerns and doing well!

Thanks for putting so much into this. I have learned a lot so far and think this is a diet I can live by. My hubby and I are already getting the hang of sharing plates when we go out and I have started cutting my portion sizes way back.

I thank you so much for your advice and information. I have had diabetes for 5 years and just started insulin 1 month ago. I struggle, a lot because I eat what is here and dont have alot to spend on the special things. I gave up my coffee creamer because it seemed to spike my BS and started using 2% milk but wonder if this is any better? Also, i work 2 jobs and start my day at 2 a.m. and go to bed at 10 p.m. should I be spreading out my 5 small meals throughout? Right now I just drink coffee or tea until 7:30 and then start my "eating day" but my BS is always spiked before breakfast??

There's a bit too much in your post to discuss here. If you would like to email me at buaws-tambrajak@yahoo.com.au I am happy to chat with you directly.

I'll make just one suggestion here. Eat something as soon as possible after you wake. It doesn't have to be a big meal, but enough to send your body the signal that you aren't starving. Read this for more detail: http://loraldiabetes.blogspot.com/2009/02/i-ate-nothing-why-are-my-bgs-high.html

Alan, thanks for sharing your story. I'm wondering -- how high were your numbers during your weight loss phase, before you shifted your focus to glucose control? I'd like to do something similar, but I'm a bit concerned about my doctor's reaction to the idea.

Thanks for your perspective, and don't worry -- I do understand the difference between your own experience and medical advice.

Hello Karen. At that time, before I discovered "test, test, test" I was usually only measuring fasting and pre-dinner, with occasional tests randomly. Some of those random numbers were well above 10(180) and some were high teens in mmol/l, which is in the 250-300 range in mg/dl.

When I started testing post-prandially during the dietician's course far too many of the numbers were in the high teens. That was when I realised it was time to make some changes and the high carb advice was killing me.

PS For Karen. My fasting and pre-dinner numbers did not seem too bad during the weight loss phase and were slowly improving on my numbers at diagnosis. I thought I was doing OK until I saw those peak post-meal numbers.

Hello Alan,I was reading your comment to Linda Copeland over on Adults living with Type 2. And I found myself reading your blog. A lot of good information. When I was diagnosed I went right to this diet. I was very surprised that I was following it almost to the T! It wasn't anything any one told me. Just ideas I guess I formed! Your blog here has given me encouragement that I am on the right track! Thank you and thank you for all the help and encouragement you give others that are struggling with this life style!

Alan , thank you for cluing me into all this great information. I am looking forward to checking out the recipe book. I loved the idea of sharing when going out to eat !!!! Your style of writing is great ,makes me want to keep reading, Thank You, Lainie

That takes you to Smashwords where you have choices for several e-readers. When you get to the checkout, include coupon number YL78Y (not case-sensitive) for 15% discount for readers of this blog. The discount only applies for Smashwords sales.

Thanks Alan. You are a great source of info and I really appreciate all you have done for us type 2 diabetics. I was diagnosed April 2011 as type 2, high blood pressure, high cholesterol. I weighed in at a whopping 285 lbs. I've since lost 30.5 lbs. I've got a long way to go, but I know I will make my goal - 125 lbs. We just celebrated our 21st wedding anniv. When I loose the weight, my husband said we could renew our wedding vows. I've got my sights set on a church wedding. :-)

Great inspiration found in these pages. Thank you Alan. My first weight in was 180 lbs at 5'4". Started matching my carb intake to my glucometer readings and have lost 4 lbs. I have a long way to go, and all the optimism in the world.

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For those who prefer reading a book to a computer screen:

Whether you have just been diagnosed or you have been fighting this condition for many years "what on earth can I eat?" is the single most confusing question facing you as a type 2 diabetic. This book is intended to help you answer that question - for you. The book shows you how to find an enjoyable way of eating that suits you, and you alone, to help control blood glucose levels, achieve and maintain optimum weight, supply good nutrition and minimise the possibility of future diabetes complications. The book also includes an effective weight loss plan and some recipes.

The book is in English but can be bought from the following national sites in the local currency:

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